CONTRACTORS HSE EQUIPMENT PRE-MOBILIZATION CHECK LIST

DATE: . PROJECT TITLE: ...... CONTRACTOR: . CONTRACT NO: . LOCATION: . DEPARTMENT: .

S/N DESCRIPTION (REQUIREMENTS)

1 2 HSE PLAN SECURITY PLAN

AVAILABLE Y/N

QTY

CHECKED (OK) Y/N

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HARD HAT COVERALL (Long sleve with Printed companys name) RAIN COAT HAND GLOVE SAFETY SHOE SAFETY BOOT/STEEL TOE RAIN BOOT EYE GOGGLE ( Specified) WELDING SHIELD NOSE MASK ( Respirators as Specified) DUSK MASK EAR MUFF SAFETY HARNESS LIFE VEST FIRST AID BOX WITH ADEQUATE CONTENT & FIRST AID ADMINISTRATION REGISTER FIRE EXTINGUISHER WITH VALID INSPECTION DATE MAN HOUR BOARED NOTICE BOARED ADEQUATE WARNING SIGNS NO PPE NO ENTRY NO ENTRY TO UNAUTHORISED PERSON MUSTER POINT WASTE DUMP KEEP OFF FLYING OBJECT WATCH OUT FALLING OBJECT KEEP OFF CAUTION TAPES HSE OFFICER COMPETENCY (NISP LEVEL 3) FIRST AIDER QUALIFICATIONS NOTE BOOKS SUPERVISOR AND HSE OFFICER APPOINTMENT LETTER BOX AND FLAT FILE RETAINERSHIP CLINIC WITH EVIDENCE MEDICAL CERTIFICATES OF PERSONNEL DRINKING WATER FACILITIES (CUPS) EMERGENCY ALART SYSTEM LIST OF WORKERS WITH PHOTO COPY OF COMPANY ID CARDS KICK-OFF MEETING SIGNED OFF HEMP TRAINING SIGNED OFF OFFICE SPACE

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6nos

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This is to certify that the contractor has met all HSE Requirements to Mobilize to site and commence work

This document when printed is an uncontrolled copy

Sign:

CONTRACTORS REP:

IFM HSE Support.